title: Home enteral feeding: analysis and improvement of organizational models.
abstract: OBJECTIVE
  The purpose of this study was to analyze the organizational models of home enteral feeding used in 5 local health authorities (LHAs) in the Veneto region (Italy). By comparing these models with the main guidelines, the authors have attempted to determine the "minimum standards" to be adopted at an organizational level.
  
  
  METHODS
  This 3-stage study analyzes procedures, precoded actions, and recordable processes. Stage 1: objectives were defined, work methods selected, and reference guidelines chosen. Stage 2: flowcharts were drafted to show the actions and work paths taken for the 5 LHAs. Stage 3: flowcharts were compared with data from the literature.
  
  
  RESULTS
  The study shows that very different organizational models exist. For instance, by comparing organizational processes with the procedures prescribed by the guidelines, it can be seen that the mean percentages of actions taken by the 5 LHAs, for patients in both rest homes and nursing homes, rarely exceeds the threshold of 50% (on a scale from 0% to 100%).
  
  
  CONCLUSIONS
  This study shows that home enteral feeding is neither optimized nor uniform in the 5 LHAs and that standardized methods are not used for clinical monitoring.
authors.affiliation: Metabolic and Nutrition Unit, Local Health Authority ULSS 9, Veneto, Italy. apaccagnella@ulss.tv.it
authors.forename: Agostino
authors.initials: A
authors.lastname: Paccagnella
authors.forename: Maria Lisa
authors.initials: ML
authors.lastname: Marcon
authors.forename: Stefania
authors.initials: S
authors.lastname: Rebuffi
authors.forename: Antonella
authors.initials: A
authors.lastname: Garna
authors.forename: Alessandra
authors.initials: A
authors.lastname: Mauri
authors.forename: Daniela
authors.initials: D
authors.lastname: Maccari
authors.forename: Patrizia
authors.initials: P
authors.lastname: Paiusco
authors.forename: Nello
authors.initials: N
authors.lastname: Spinella
mesh_terms: D003153:Community Health Services; D004750:Enteral Nutrition / Q000379:methods*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006699:Home Care Services; D006801:Humans; D007558:Italy; D017146:Models, Organizational; D009735:Nursing Homes; D016730:Program Development; D058996:Quality Improvement / Q000458:organization & administration